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Dentists  as  Specialists. 


Geo,  L,  Parmele,  M,  D,.  d;  M,  D, 


READ    BEFORE    THE 


AMERICAN  ACADEMY  OF  DENTAL  SCIENCE, 


Fourteenth  Annual  Meeting, 


Hnstan^  Oct,   2Bj  IBBl, 


Reprinted  from   New   England  Journal  of  Dentistry. 


SPRINGFIELD,  MASS. 

WEAVER,    SHIPMAN   AND   COMPANY,    PKINTERS. 

1882. 


Dentists  as  Specialists. 


Geo,  L,  Parmele,  M,  D„  D,  M,  D, 


^  READ    BEFORE   THE 


AMERICAN  ACADEMY  OF  DENTAL  SCIENCE. 


Fourteenth  Annual  Meeting, 


BDstnn,  Oct,  2S,  IBHl, 


Reprinted  from   New  England  Journal   of  Dentistry. 


SPRINGFIELD,  MASS. 

WEAVER,    SHIPMAN   AND   COMPANY,    PRINTERS. 

1882. 


Dentists  as  Specialists, 


In  the  Code  of  Ethics  of  nearly  every  Dental  Association  in  the 
United  States,  under  the  heading,  "  The  Relative  Duties  of  Dentists 
and Fhysiciafis,^^  appears  this  assertion  :  "  Dental  Surgery  is  a  specialty 
in  medical  science.  Physicians  and  dentists  should  both  bear  this  in 
mind."  Although  the  idea,  as  expressed  in  this  extract  from  the 
Code,  ought  to  be  true,  and  I  sincerely  trust  the  day  may  not  be  far 
distant  when  it  will,  I  beg  leave  to  declare  that  in  my  opinion  dentistry 
as  now  practiced  by  the  majority  of  dentists  is  not  a  specialty  of  med- 
icine. Surely  a  profession  or  art  in  which  one-eighth  of  the  practi- 
tioners are  graduates  of  dental  schools,  one-eightieth,  perhaps, 
graduates  of  medicine,  and  the  balance  (about  three-fourths)  possessors 
of  no  degree  either  academic  or  scientific,  has  no  right  to  claim  equal 
standing  with  a  profession  whose  members,  with  a  few  exceptions, 
have  a  scientific  education  and  graduation.  I  would  not  have  you  think 
that  I  place  a  hght  estimate  upon  the  rapid  gi"owth  and  improvement 
of  a  science  so  important  to  the  comfort  and  well-being  of  man- 
kind, for  I  agree  with  you  all  in  thinking  that  the  advancement  of 
dentistry  during  the  past  century  cannot  be  equalled  by  any  other 
department  of  science.  Neither  do  I  desire  to  place  a  damper  on 
the  energy,  industry  and  effort  that  has  been  expended  to  develop  our 
calling  to  its  present  standing,  but  rather  to  stimulate  still  further 
advance  in  a  new  direction.  Whoever  reads  our  journals  and  the 
transactions  of  our  associations,  cannot  fail  to  have  noticed  that  there 
is  a  desire  on  the  part  of  the  dental  profession  to  be  recognized  by 


4  DENTISTS   AS   SPECIALISTS. 

the  medical  profession  as  equals,  and  we  also  see  it  stated  that  we  are 
specialists  of  medicine  and  ought  to  be  recognized  as  such. 

What  now  are  the  relations  really  existing  between  regular  medical 
and  dental  graduates  (leaving  out  entirely  those  who  have  no  degrees 
whatever)  ?  Merely  pleasant  and  kindly  feelings — that  is  all.  It  is 
useless  to  deny  that  they  are  not  yet  what  they  should  be,  nor  will 
they  be  until  our  members  are  regular  graduates  of  medicine,  having 
followed  the  same  course  of  training  that  members  of  the  medical 
profession  and  all  specialists,  with  the  exception  of  dentists,  pursue. 
Until  that  day  arrives,  dentistry  is  not  a  specialty  of  medicine.  I  have 
always  believed  that  dentistry  ought  never  to  have  been  estabhshed  as 
a  separate  profession ;  but  that  every  person  desiring  to  practice  in 
any  department  of  medicine  should  be  required  to  follow  a  regular 
course  of  medical  education,  and,  having  graduated  as  a  doctor  in 
medicine,  to  then  perfect  himself  in  the  desired  department.  Thus  it 
is  that  those  who  practice  ophthalmology,  otology,  gynecology,  etc., 
are  educated,  and  why  should  not  those  desiring  to  be  dental  and 
oral  surgeons  be  required  to  educate  themselves  in  the  same  way? 
Dentists  are  not,  and  never  can  be,  specialists  of  medicine  and  recog- 
nized by  the  medical  profession  as  such  until  they  are  educated  in  the 
same  manner  as  other  speciahsts.  When  such  rules  are  complied 
with  there  need  be  no  fear  but  that  the  medical  profession  will  give 
us  the  "  right  hand  of  fellowship." 

We  again  hear  it  said  that  a  thorough  medical  education  is  not 
requisite  to  a  dentist,  and  that  it  is  useless  to  spend  the  time  required 
to  obtain  a  medical  degree,  and  the  additional  time  necessary  to  obtain 
the  desired  dental  training;  also  that  one  who  is  an  M.  D.  is  no  bet- 
ter qualified  for  our  department  than  a  D.  D.  S.  Allow  me,  in  answer 
to  these  points,  and  as  expressing  my  views,  to  quote  from  the  address 
of  Dr.  J.  T.  Hodgen  of  St.  Louis,  President  of  the  American  Medical 
Association,  delivered  at  the  thirty-second  annual  meeting,  in  May 
last,  at  Richmond,  at  which  time  you  are  aware  a  new  section  entitled 
dentistry  was  established  as  one  of  the  sections  of  that  association. 
In  his  address.  Dr.  Hodgen  spoke  as  follows  : 


DENTISTS  AS   SPECIALISTS.  O 

"  A  simple  knowledge,  however  accurate,  of  the  parts  involved  does 
not  qualify  one  to  make  an  intelligent  prognosis,  to  decide  upon  the 
advisability  of  an  operation,  or  treat  judiciously  even  such  diseases 
as  consist  mainly  in  pathological  changes  in  the  part  in  question — to 
say  nothing  of  the  many  cases  in  which  subjective  symptoms  are 
referred  to  a  particular  part,  when  they  are  in  fact  but  the  local 
expression  of  some  remote  or  possibly  constitutional  trouble.  Herein 
lies  a  danger  which  threatens  the  profession  through  the  adoption  of 
exclusive  specialties  by  those  not  well  trained  in  general  medicine.  It 
cannot  be  denied  that  the  early  and  exclusive  study  of  the  affections 
of  a  part  tends  to  narrow  the  intellectual  grasp  and  cramp  the  powers 
of  the  man  who  yields  to  the  influences  incident  to  such  partial  train- 
ing. In  the  best  sense,  a  speciaHst  is  a  physician  and  something 
more ;  in  the  worst,  he  is  something  else  and  something  less  than  a 
physician." 

A  short  time  since  in  England,  before  the  General  Council  of  Med- 
ical Education  and  Registration,  the  question  arose  whether  a  diploma 
from  a  college  of  surgeons  was  a  higher  qualification  in  dentistry,  and 
whether  dentists  who  held  medical  and  surgical  qualifications  should 
have  them  added  to  their  description  in  the  Dental  Register.  During 
the  discussion.  Sir  James  Paget  said*  "  that  proper  dentistry  was  some- 
thing more  than  a  mechanical  art ;  but  an  ordinary  dentist's  qualifica- 
tions did  not  imply  the  possession  of  much  more  than  a  hmited 
amount  of  knowledge.  A  man  of  such  a  qualification  would  not 
know  much  of  such  things  as  the  state  of  the  liver,  presence  of  gout, 
&c.,  on  which  the  treatment  of  the  teeth  might  turn.  Again,  as 
regarded  diseases  of  the  jaws,  no  doubt  a  dental  education  gave  much 
help,  but  a  surgical  education  gave  much  more.  Any  one  who  de- 
votes himself  to  the  special  treatment  of  one  part  of  the  body  was 
less  qualified  for  this  than  the  man  who  studied  the  whole  frame. 
Again,  it  was  important  to  excite  members  of  the  dental  profession  to 
seek  more  knowledge  than  they  possessed,  for  the  profession  would 

*British  Medical  Journal,  May  7,  1881. 


6  DENTISTS   AS    SPECIALISTS. 

rise  as  this  knowledge  was  acquired.  In  tlie  journals  of  dentistry, 
the  papers  written  by  members  of  the  College  of  Surgeons  were  of  a 
higher  class  than  others."  Dr.  McClintock  held  that  special  practice 
was  improved  by  more  extended  education.  Dr.  Pyle,  Mr.  Spence, 
Dr.  Stojjlrar  and  several  others  expressed  similar  views  with  Sir  James 
Paget.  It  would  seem  to  me,  then,  that  the  proper  way  to  place  den- 
tistry where  it  should  be,  making  it  a  specialty  of  medicine,  would  be 
to  abolish  its  present  system  of  exclusive  education,  conferring  no 
longer  the  degrees  of  D.  D.  S.,  or  D.  M.  D.,  unless  they  be  used  as 
an  appendage  to  the  degree  of  Doctor  in  Medicine.  Let  Oral  Hos- 
pitals be  established  and  Professors  of  Oral  Science  be  appointed  in 
our  Medical  Schools.  I  am  well  aware  that  the  views  expressed  in 
this  paper  are  not  entirely  new,  but  as  "  a  continual  dropping  weareth 
away  the  stone,"  I  venture  to  present  them  to  you  so  that  by  continu- 
ally keeping  the  subject  before  the  profession  an  impression  may  at 
last  be  made. 

In  conclusion,  I  would  earnestly  recommend  that  that  portion  of 
our  Code  of  Ethics  quoted  at  the  opening  of  this  paper  be  abolished 
until  such  time  as  it  can  be  used  with  propriety ;  and  let  me  urge  all 
among  you,  w'ho  are  graduates  of  jnedicine,  to  connect  themselves 
with  the  medical  society  of  their  county,  from  which  they  can  go  as 
delegates  to  the  American  Medical  Association,  which  meets  the  first 
Tuesday  in  June  next,  at  St.  Paul,  Minnesota.  Let  those  who  have 
not  yet  obtained  the  medical  degree  leave  no  stone  unturned  until 
they  have  earned  their  diploma  in  medicine,  for  by  so  doing  they  will 
not  only  advance  their  o\sti  interests  but  will  hasten  the  day  when  den- 
tistry will  be  A  Specialty  of  Medical  Science. 


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